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Background. Healthcare placements in dietetics education contribute significantly to student learning. Exploring students’ self-conceptualisation of placement experiences may provide insights to better support learning. Self-determination theory (SDT) has been used to seek insight into clinical and educational settings but has not yet been applied to dietetic placement learning. This study investigated dietetics students’ reflections of key influences on placement learning experiences and their alignment with an SDT framework.\ud \ud Methodology. A post-placement two-stage critical incident debrief was conducted with seven successive cohorts (168 students) of dietetic undergraduate students on final placement. In debriefs, students’ anonymous themes were collected and discussed, inductively analysed, and then mapped against an SDT framework of psychological and motivational constructs. \ud \ud Results. Nine key themes were identified that impacted upon placement experiences. Four themes related to framework constructs: 1. Supervisor (and peer) autonomy support: 2. Perceived competence; 3. Relatedness; and, 4. Autonomy and intrinsic motivation. Non-SDT themes were also present including: 5. Learning environment and experience; and, themes about professional behaviours and identity: 6. Teamwork and interactions, 7. Managing emotions and self-care, 8. Dietetic professional communications and behaviours and, 9. Developing a professional identity.\ud \ud Conclusions. Embedding a structured debrief in the curriculum and using a psychological motivational SDT framework to analyse themes arising can provide valuable information about the learning needs of students on placement with potential for wider application in dietetic learning and teaching and workforce employability. The current findings may have application in university curricula before and after professional placement.

The aim of this systematic review, meta-analysis and meta-regression was to examine the relationship between type 2 diabetes mellitus (T2DM) and concentration of zinc in whole blood, as well as dietary zinc intake. Searches were performed using Ovid MEDLINE, Embase (Ovid) and The Cochrane Library (CENTRAL). Observational studies conducted on diabetic and healthy adults, with data on dietary zinc intake and/or concentration of zinc in whole blood, were selected. The search strategy yielded 11,150 publications and the manual search 6, of which 11 were included in the meta-analyses. Mean difference (MD) and 95% confidence interval (CI), were calculated using the generic inverse-variance method with random-effects models. Heterogeneity was assessed by the Cochran Q-statistic and quantified by the I2 statistic. Meta-regressions and stratified analysis were used to examine whether any covariate had influence on the results. The pooled MD for the dietary zinc intake meta-analysis was −0.40 (95% CI: −1.59 to 0.79; I2 = 61.0%). Differences between diabetic and non-diabetic subjects became significant in the presence of complications associated with diabetes (MD = −2.26; 95% CI: −3.49 to −1.02; I2 = 11.9%). Meta-regression showed that for each year since the diagnosis of diabetes the concentration of zinc in whole blood decreased in diabetic patients regarding healthy controls [MD (concentration of zinc in blood) = 732.61 + (−77.88303) × (duration of diabetes in years)], which is not generally explained by a lower intake of zinc.

Background There is a need for theory-driven studies that explore the underlying mechanisms of change of complex weight loss programmes. Such studies will contribute to the existing evidence-base on how these programmes work and thus inform the future development and evaluation of tailored, effective interventions to tackle overweight and obesity. This study explored the mechanisms by which a novel weight loss programme triggered change amongst participants. The programme, delivered by a third sector organisation, addressed both diet and physical activity. Over a 26 week period participants engaged in three weekly sessions (education and exercise in a large group, exercise in a small group and a one-to-one education and exercise session). Novel aspects included the intensity and duration of the programme, a competitive selection process, milestone physical challenges (e.g. working up to a 5 K and 10 K walk/run during the programme), alumni support (face-to-face and online) and family attendance at exercise sessions. Methods Data were collected through interviews with programme providers (n = 2) and focus groups with participants (n = 12). Discussions were audio-recorded, transcribed and analysed using NVivo10. Published behaviour change frameworks and behaviour change technique taxonomies were used to guide the coding process. Results Clients’ interactions with components of the weight loss programme brought about a change in their commitment, knowledge, beliefs about capabilities and social and environmental contexts. Intervention components that generated these changes included the competitive selection process, group and online support, family involvement and overcoming milestone challenges over the 26 week programme. The mechanisms by which these components triggered change differed between participants. Conclusions There is an urgent need to establish robust interventions that can support people who are overweight and obese to achieve a healthy weight and maintain this change. Third sector organisations may be a feasible alternative to private and public sector weight loss programmes. We have presented findings from one example of a novel community-based weight loss programme and identified how the programme components resulted in change amongst the participants. Further research is needed to robustly test the effectiveness, and cost-effectiveness, of this programme. Electronic supplementary material The online version of this article (doi:10.1186/s12889-016-3063-4) contains supplementary material, which is available to authorized users.